18 Slecht nieuws boodschappen.The training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

19 Je bent erg sportief en lid van een basketbal club. Stel:Je bent erg sportief en lid van een basketbal club.Je hebt een auto ongeval gehad en na revalidatie wordt het duidelijk dat je een blijvend letsel zult overhouden. Je zult je knie nooit meer kunnen plooien waardoor je sportieve prestaties tot nul herleid worden.Wil je deze boodschap horen?Wanneer?Op welke manier?The training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

20 Wat men meestal op deze vraag antwoordt:PositiefZo snel mogelijkKort en bondigZonder omwegenMet ruimte voor reactieOp een rustige plaatsNegatiefOver de telefoonMet veel omwegenNiet meedelenOnrealistische verwachtingen scheppenTe snelZonder emotie van de hulpverlenerThe training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

21 Is dit ook voor patiënten zo?Stellingen.Stelling 1Sommige patiënten willen de waarheid gewoon niet horenThe training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

22 Sommige patiënten kunnen de waarheid niet aanStelling 2Sommige patiënten kunnen de waarheid niet aanThe training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

23 Let goed op, op welk tijdstip je slecht nieuws brengtStelling 3Let goed op, op welk tijdstip je slecht nieuws brengtThe training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

24 Patiënten voelen zelf wel hoe het met hun lichaam gesteld isStelling 4Patiënten voelen zelf wel hoe het met hun lichaam gesteld isThe training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

25 Stelling 5Als de familie vraagt om niets tegen de patiënt te zeggen, moet ik dat respecterenThe training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

26 Erover praten geeft negatieve emotieStelling 6Erover praten geeft negatieve emotieThe training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

27 Hulpverleners kunnen moeilijk om met negatieve emotieAfleidingsmanoeuversDe pil verguldenDe “hang yourself” methodeBagatelliserenTwee beentjes eraf is ergerU bent één van velenIk kan er ook niets aan doenThe training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

28 Hoe slecht nieuws brengen?Voorbereiding:Waar en wanneer vindt het gesprek plaats?Wie zal het slechte nieuws brengen?Wie zijn als “toehoorders” aanwezig?Hoe zal het nieuws meegedeeld worden?Welke reacties verwacht men van de patiënt?Hoe denkt de hulpverlener dat hij zelf zal reageren?Welke toelichting moet in dit eerste contact zeker nog gegeven worden?The training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

29 Prestatieniveau Rationeel gebied Sterkte van de emotie.The training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.Sterkte van de emotie.

30 Mate van emotie Empathie Rationeel gebied Informatie TijdThe training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.InformatieTijd

31 Belangrijkste stappen in het brengen van slecht nieuws.MededelingFrustratieverminderingProbleem oplossingOnmiddelijk meedelen, kort, bondig, essentiële boodschap.Empathie, gevoelens verwoorden, steungevende aanwezigheidLuisteren naar de richting die de patiënt zelf aangeeft, ingaan op onderliggende gevoelens, eventueel adviezen geven.The training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

32 Hoe reageren patiënten?SchrikOngeloofHerhalingenAgressieVerwijten aan zichzelf of aan een anderVerdriet en wanhoopOntkenningVerdringingEmotionele manipulatie.The training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.

33 Aanvullende uitleg geven.Wees karig, slecht nieuws vraagt tijd.Wacht op reactie voor je verder gaatLet op de emotie van de patiënt, onder emotie kan men nietluisterenGun de patiënt tijd voor verwerkingOplossingen passen meestal niet in een eerste gesprek.Slecht nieuws vraagt tijd, lukt meestal niet in één gesprekThe training during the first year is build on three basic skills: listening, being empathic and handling emotions. Students have be able to listen without interrupting another person and to hear and recall the story. They learn to deal with the information flow and to look at their individual preferences and resistances with received information. They have to be able to name emotions during the conversation. Special attention is give on doing this on ‘a natural way’. E.g. “This must be sad for you” in stead of “I think you must feel sad”.Students have to be able to pick up emotional cues, to explore them and to handle them within a conversation. The strong emphasis is put on the awareness for every student of his own strengths and weaknesses. The training starts with a plenary session for all students where the necessity of communication within the medical curriculum is expressed. Evidence is given.After that session, student participate in small groups. The training consists of 4 sessions of 2 hours in small groups (12 tot 14 students) spread over the whole academic year. All kinds of techniques are used: looking at video tapes, recall stories, role play with colleagues, role play with actors.